Look up the most recent NPI and PECOS records

Mark Henry

Emergency Medicine

Allopathic & Osteopathic Physicians

University Hospital, L4, Stony Brook, NY 11794-0001

PECOS Enrollment

Based on the most recent information from CMS, provider Mark Henry is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1225066905
Provider Type
Individual
Full Name
Henry, Mark
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/29/2006
Last Updated
7/8/2007

Contact Information

Practice Location

University Hospital, L4, Stony Brook, NY 11794-0001

(631) 444-2499

Unlisted Fax

Mailing Location

PO Box 1559, Stony Brook, NY 11790-0989

(631) 444-2499

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 125487 New York

Provider Identifiers

ID	Description	Issuer
ID 7794574	Description Other	Issuer AETNA New York
ID 25A12	Description Other	Issuer EMPIRE BC.BS New York
ID 00435727	Description Medicaid	Issuer Unlisted New York

Mark Henry

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Fernandez, Claudia Veronica

Nocito, Robert M

Wyler, Benjamin Aaron

Ho, Dieu-Huong Thi

Cox, Lincoln

Garra, Gregory

Lim, Aaron Tungyin

Viccellio, Asa

Packy, Theodore F

Morley, Eric J